The Benefits of Exercise and Pelvic Floor Physiotherapy During Perimenopause and Menopause
The journey through perimenopause and menopause can be a significant time of transition for women/ assigned female at birth, often accompanied by a wide range of physical and emotional changes. Hormonal fluctuations during this period lead to symptoms such as hot flashes, mood swings, sleep disturbances, and weight changes. However, a frequently overlooked but common issue is the weakening of overall strength, bone health, and pelvic function. Fortunately, the right combination of exercise and pelvic floor physiotherapy can help with gaining strength, improving their well-being, and managing specific pelvic floor-related symptoms, thereby enhancing their quality of life during perimenopause and menopause.
Understanding Perimenopause and Menopause
Perimenopause refers to the phase leading up to menopause, during which the production of oestrogen and progesterone—two primary female hormones—begins to decline. This phase can last anywhere from a few months to several years. Menopause itself is defined as the absence of menstruation for 12 consecutive months, marking the end of a woman’s reproductive years.
A notable physiological change during this time is the weakening of the pelvic floor—a group of muscles and connective tissues that support the bladder, uterus, and bowel. The decline in oestrogen levels contributes to changes in the pelvic, vulvar, and vaginal tissues, which can result in symptoms such as urinary and faecal incontinence (leaking urine or stools), urgency (rushing to the bathroom), pelvic organ prolapse, and discomfort during intercourse.
In addition to these pelvic symptoms, one can also experience a reduction in muscle mass and bone density, making strength training crucial for maintaining health, mobility, and balance during perimenopause and menopause.
The Importance of Exercise During Menopause
Exercise is an invaluable tool for transitioning through perimenopause and menopause, offering numerous physical, mental, and emotional benefits. Here’s why incorporating exercise, especially strength training, is essential during this period:
1. Strengthens Muscles and Bones
During menopause, many experience a natural decline in muscle mass (sarcopenia) and bone density, which increases the risk of osteoporosis. Regular strength training can help counteract these losses by promoting muscle growth and maintaining bone density. Weight-bearing exercises and resistance training are particularly effective for strengthening muscles and bones.
2. Improves Metabolism and Weight Management
Hormonal changes during menopause often lead to weight gain, particularly around the abdomen. With a slower metabolism and loss of lean muscle mass, it becomes easier to gain fat. However, a balanced exercise routine that combines aerobic activities (such as walking, cycling, or swimming) with strength training can help maintain a healthy weight, improve body composition, and boost metabolism.
3. Boosts Mood and Mental Well-being
Exercise has well-known benefits for mental health. For those going through perimenopause and menopause, it can be especially helpful for managing mood swings, anxiety, and even depression. Physical activity stimulates the release of endorphins—"feel-good" hormones—that enhance mood and reduce stress.
Pelvic Floor Physiotherapy: A Targeted Approach
Pelvic floor physiotherapy focuses on strengthening the pelvic floor muscles, which play a critical role in bladder and bowel control, sexual function, and overall pelvic health. For those going through perimenopause and menopause, pelvic floor physiotherapy can be particularly beneficial for addressing some of the most common and distressing symptoms.
1. Reduces Urinary and Fecal Incontinence
One of the most prevalent symptoms during menopause is incontinence, particularly stress urinary incontinence, which may occur during activities such as sneezing, coughing, or exercising. Pelvic floor physiotherapy can strengthen the pelvic floor muscles, improving bladder and bowel control and reducing or even eliminating leakage.
2. Prevents and Manages Pelvic Organ Prolapse
Weakened pelvic floor muscles increase the risk of pelvic organ prolapse, in which the bladder, uterus, or bowel may shift into the vaginal area due to a lack of support from the ligaments. While menopause is not necessarily the main cause of prolapse, the decreased lubrication and sensitivity in vulvar and vaginal tissues due to declining estrogen levels may make women more aware of their prolapse. Pelvic floor exercises, when combined with a personalized approach guided by a pelvic floor physiotherapist, can help restore strength and manage symptoms, preventing further prolapse or worsening of the condition.
3. Improves Sexual Health and Function
Menopause can lead to vaginal dryness, discomfort during intercourse, and decreased sexual function. Strengthening and improving coordination of the pelvic floor muscles can increase blood flow to the pelvic region, improve sensation, and enhance sexual satisfaction. Pelvic floor physiotherapy can also alleviate discomfort and support overall sexual health.
Combining exercise with pelvic floor physiotherapy provides a holistic approach to managing menopause-related changes. Together, they can improve core strength, posture, and functional movement, while addressing pelvic floor issues directly. Exercises like squats, bridge poses, and Kegels not only build overall strength but also help to engage and strengthen the pelvic floor, supporting bladder control and preventing prolapse.
Exercise and pelvic floor physiotherapy play a vital role in helping women navigate the physical changes that occur during perimenopause and menopause. From building muscle strength and improving bone density to alleviating pelvic floor-related symptoms, these interventions can significantly enhance the quality of life during this transitional period. By incorporating strength training, aerobic exercise, and targeted pelvic floor exercises into their routine, women can gain strength, improve pelvic health, and enjoy a more empowered, symptom-free menopause experience.
Remember, menopause is not just a time of physical transition but also a period of reflection, offering an opportunity to better understand your body and embrace the changes happening in your life. So, as you navigate this phase, consider how you can best support your body through exercise and, whenever necessary, your “pelvic floor care.
Always consult with a healthcare provider before starting any new exercise program, especially if you are experiencing pelvic floor symptoms, to ensure the approach is tailored to your individual needs.